Karyn e. Polito



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CHARLES D. Baker

Governor


KARYN E. POLITO

Lieutenant Governor

The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health

Division of Health Professions Licensure Board of Registration in Nursing


239 Causeway Street, Suite 500, Boston, MA 02114
Tel: 617-973 0900

TTY: 617-973-0988



http://INWVV. mass .gov/dph/boards/rn

MARYLOU SUDDERS

Secretary

MONICA BHAREL, MD, MPH

Commissioner




Sent Via U.S. Certified Mail No. 7012 3460 0003 3582 0031


NOTICE OF FINAL BOARD ACTION
September 17, 2015 Ifonie Cazimir
Re: Final Decision-Denial of Initial Application for Registered Nurse

Licensure by Reciprocity

Dear Ms. Cazimir:
On September 9, 2015 the Board of Registration of Nursing ("Board") held a hearing and received evidence in an Executive Session during its regularly scheduled meeting to consider your application for initial licensure as a Registered Nurse ("application)'). Pursuant to M.G.L.c. 30A § 21, written notice of the hearing was sent to you. However, you were not present at the hearing. At the hearing, the Board's Complaint Resolution Coordinator, Ms. Heather Cambra presented evidence that was obtained with your application to determine your compliance with the Good Moral Character (GMC) required by M.G.L.c. 112 §76. Specifically, Ms. Cambra presented information that your application for Initial Licensure by Reciprocity and Verification Form contained fraudulent information.
After review of the provided materials, the Board determined you do not meet its GMC licensure requirement, therefore your application for licensure as a Licensed Practical Nurse is DENIED. You may not reapply for nurse licensure until five years from the date of the hearing in this matter (9/9/15). Denial of an application for licensure is a disciplinary action and shall be reported to other licensing boards, law enforcement entities, and other individuals or entities as required or permitted by law.
You are hereby notified that this License Denial is a final agency action. You are hereby notified that you have a right to appeal this action within thirty (30) days of your receip


tof this notice to either the Superior Court for Suffolk County or the county where you reside, pursuant to M.G.L.c. 30A §14.
Sincerely,
Heather Cambra BSN, RN, JD

Board of Registration in Nursing






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